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Chapter 4 - Immunological Properties of Botulinum Neurotoxins

Published online by Cambridge University Press:  02 November 2023

By
Hans Bigalke ,
Dirk Dressler  and
Jürgen Frevert
Edited by
Daniel Truong ,
Dirk Dressler ,
Mark Hallett ,
Christopher Zachary  and
Mayank Pathak
Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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Summary

Botulinum neurotoxin is used to treat a large number of muscle hyperactivity disorders, including dystonia, spasticity, and tremor; autonomic disorders such as hyperhidrosis, hypersalivation and various bladder disorders; and pain conditions, especially chronic migraine. Aesthetic applications have also become a large indication. Commercially available preparations of Bont/A and BoNT/B are listed.

The active component in all products is BoNT, a di-chain protein of 150 000 daltons. BoNT/A inhibits release of acetylcholine by cleaving the SNARE protein SNAP-25 while BoNT/B cleaves VAMP II. Since BoNT is a foreign protein, the human immune system may respond to it with the production of specific anti-BoNT antibodies (BoNT-AB).

The probability of developing BoNT-AB increases with the amount of BoNT applied at each injection series. Other drug- and patient-related factors might contribute to the immune response. Unspecific activation of the immune system as a possible risk factor for BoNT-AB formation is currently been discussed in connection with COVID-19 vaccination programs. A pre-activation of lymphocytes may have triggered BoNT/A-AB formation. In this chapter, a method is presented for the quantification of BoNT-AB in sera, the immune cell reactions to antigens are described and drug related immune responses are discussed.

Keywords

anti-BoNT antibodiesBoNT-ABmouse bioassaymouse diaphragm assaycomplexing proteinsneutralizing antibodies
Type
Chapter
Information
Manual of Botulinum Toxin Therapy , pp. 18 - 22
Publisher: Cambridge University Press
Print publication year: 2023

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